CISSS de l’Outaouais (CISSSO)

CLSC in Low saved

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By Trevor Greenway

The Low CLSC has been spared. It will not close, and it will not be reduced to one day a week, according to the CISSS de l’Outaouais (CISSSO). 

The CLSC in Low was, at one point this spring, on the chopping block to either close or reduce its hours to just one day a week. However CISSSO has confirmed to the Low Down that “there is no change to the CLSC’s service offer” in Low. 

“Local services are important to the population, especially those on the outskirts of urban areas. We are working to maintain them,” Santé Québec spokesperson Marianne Paquette told the Low Down.

This welcome but surprising decision to keep the Low CLSC open comes as part of a wider announcement by Santé Québec that that the initial $90 million that CISSSO was mandated to cut from its budget has been slashed in half – down to $45 million. With CISSSO having already cut $60 million from its budget in January, no more funding cuts are coming to the Outaouais. 

“The CISSS de l’Outaouais has a budget optimization target of $45 million. Given that we have already implemented measures to meet the objectives of the last financial period, no further measures will be implemented in terms of job cuts or major reorganizations,” Santé Québec spokesperson Qeren Boua told the Low Down in an email. “As our efforts in the last period amounted to almost 60 million, the remaining dollars will be used to absorb, among other things, the cost of inflation.”

In mid-March, CISSSO cut $60 million from its budget in an effort to help Santé Québec to slash $1.5 billion from its healthcare network. Those cuts came in the form of 800 health positions being abolished – a majority of them vacant jobs. The actual job cuts were around 100 staff, mostly in administrative positions. Santé Québec’s latest budget will see it cut $1 billion from its health network instead of $1.5 billion.

Paquette said that the province’s centralized health department is using three criteria to finalize and “optimize” budgets across regions, with tightening spending at the forefront. 

Paquette said her agency will have a “complete and more accurate picture of the situation” once its audited financial statements for Santé Québec are approved by its board of directors in June. 

MRC Vallée-de-la-Gatineau Prefect Chantal Lamarche told the Low Down in April that she would “refuse” to see the Low CLSC close. After hearing about Santé Québec’s budget revisions this week, she was much happier.

“This is excellent news for our community, and I would like to highlight the work done in collaboration with the CISSSO to get to this point,” wrote Lamarche in an email. “I remain committed to defending the accessibility and quality of health services in our region.” 

Despite slashing the amount of what needed to be cut in half, advocates say they worry about the current state of healthcare in the region, as a cut of $45 million still puts the Outaouais far below funding compared to other regions of Quebec. 

“Reducing from $90 million to $45 million is not a victory; it is proof that the initial approach lacked nuance and would have unfairly impacted an already vulnerable region,” said SOS Outaouais spokesperson Jean Pigeon in a statement last week. 

He noted that the Observatoire de développement de l’Outaouais has estimated that the Outaouais region faces a funding shortfall of $180 million when compared to other regions in Quebec. 

“It is imperative that the government finally take our regional realities into account,” he said.

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Closed OR rooms…so he has to leave

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By Trevor Greenway

An anesthesiologist from Chelsea is being forced to find work elsewhere in the province because there aren’t enough functional operating rooms in the Outaouais. 

Staffing levels are so low at the CISSS de l’Outaouais (CISSSO) that just seven out of the region’s 19 operating rooms will be functional this summer, sending medical specialists like Dr. Trevor Hennessey hundreds of kilometres across Quebec and Ontario just to find work. 

“Our CISSS is dying,” said Dr. Hennessey. “Surgeons can’t operate in a hallway, and anesthetists can’t operate without the operating room team. The surgeons and anesthetists in the Outaouais are ready, willing and want to work. We’ve entered into the profession to help and care for the population, and the lack of access to the operating rooms is really a big impact.”

Hennessey, the head of anesthesiology at CISSSO, said that his department has absorbed 17 full weeks of “essentially forced time off” because there was not enough staff to open operating rooms in Hull or Gatineau. This week, Hennessey is doing replacement work at the Roberval Hospital in the Saguenay–Lac-Saint-Jean region. 

He also had to travel as far as Estrie near Sherbrooke and also had to get certification in Ontario to work at the Montfort Hospital for six weeks last year in order to give some of his local immigrant colleagues the local work.

“We brought them from overseas. We brought them with their family. They’ve moved their entire lives here, and then we tell them to sit at home and don’t work and you can’t make any money? I don’t want to lose these colleagues. I don’t want them going back home either.”

He said he’s flexible and doesn’t have kids, so he has agreed to take remote jobs so his recruited workers can stay and work locally.

The problem, according to Hennessey and healthcare advocates in the region, comes down to money – specifically salaries for nurses in Quebec, when compared to Ontario. 

According to the Fédération interprofessionnelle de la santé du Québec, nurses in Quebec with a bachelor’s degree have the lowest starting salary in the country, at $53,000 a year. It’s a significant difference in Ontario, where starting salaries for nurses are $74,000 – a staggering 40 per cent more than their Quebec counterparts. This is sending nursing staff to Ontario in droves. And the lack of nurses in operating rooms in the Outaouais means more medical technicians are leaving, including the region’s only vascular surgeon, says Hennessey. 

“We’ve lost four out of six plastic surgeons. We’ve lost a general surgeon. We’ve lost gynecologists with operating room time and lack of equipment,” said Hennessey. “We’ve lost urologists, and – most recently and the big one – we’ll be losing our last and only vascular surgeon for the entire region.”

He continued: “That is a major, major impact for the care of the population. Very sick patients will have to go to Montreal, and emergency cases will have to be transferred further to Ottawa. But when you’ve got a rupture [abdominal aortic aneurysm], every single minute counts. People with major surgeries, such as brain cancers, are going to need to wait significant periods of time.”

Hennessey noted that CISSSO nurses are “phenomenal, but boy, they’re getting tired.”

Doctors facing ‘moral distress’

Hennessey wanted to be clear that surgeons are not leaving the area solely to find work and make money, but many have left the region over what he calls “moral distress,” as doctors feel they can’t follow their duty of care in the Outaouais. 

“They feel like they can’t provide the care to the patients that they need and this is causing such distress that they need to actually leave our area to go elsewhere,” he said. “Some people feel the surgeons are leaving because they want to make money. That’s not the sole reason. They are unable to provide care and are getting phone calls week after week from patients desperate for care and they can’t provide it to them.”

He said that occupancy levels in the region in 2014 and 2017 were at 93 per cent and 90 per cent, respectively. Within 10 years, those levels dropped below 50 per cent “due to a shortage of nurses and other staff.”

A consequence of chronic underfunding

SOS Outaouais president Jean Pigeon said the latest news about reduced operating rooms is just a consequence of the region’s chronic underfunding over the last 10 years. 

According to the Observatoire de développement de l’Outaouais, it has estimated that the Outaouais region faces a funding shortfall of $180 million compared to other regions in Quebec. 

Pigeon has the same argument as many doctors and health advocates: The situation won’t improve until there is an alignment of nurse and medical technicians’ pay with those of their Ontario counterparts. 

“This is just going to slowly hurt our region more and more because nothing’s being done about it, right?” he said. “We’re the region in Quebec that has the fewest nurses per capita because … most of them are tempted to go and work elsewhere, especially in Ottawa.” Staff retention has been a constant struggle in the Outaouais region. In 2022, the Outaouais had the lowest number of nurses per resident in the province, with less than five nurses caring for every 1,000 people.

Gatineau MNA Robert Bussière did not respond to the Low Down’s call for comment. 

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Ottawa measles outbreak may have spread to Gatineau

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By Trevor Greenway

The region’s health authority is warning residents to be vigilant about measles, as an outbreak that started in Ottawa may have spread to Gatineau two weekends ago. 

Although transmission of the virus is low in outdoor settings, CISSS de l’Outaouais (CISSSO), is warning residents who were at the Éco des champs farm, located at 482 Earley Rd. in Gatineau on the morning of April 20, to monitor for symptoms and to ensure they are protected from the virus.

“Since the start of the measles outbreak in Quebec and Ontario, no cases of measles have been confirmed in the Outaouais region,” wrote CISSSO in a recent press release. “We remind the public that, although the outbreak is over in Quebec, measles cases can occur, and it is important to ensure that you are protected.”

CISSSO said that the majority of people who were at the Gatineau eco farm have already been contacted, however for those who have not, the health agency is recommending they confirm vaccination records for their children and themselves. 

You are considered protected against measles if:

  • you have received two doses of the measles vaccine (first dose after one year of age and second dose at 18 months, or with four weeks between doses);
  • you were born before 1970.

If you are not protected against measles or are unsure:

  • make an appointment via clicsante.ca or by calling 819-776-2920 to verify your vaccination status or to receive the vaccine free of charge.

Whether you are vaccinated or not, watch for symptoms of measles until May 11: 

  • fever of at least 101 F (38.3 C) and a cough/runny nose or conjunctivitis (red, light-sensitive eyes) and a red rash that starts on the face and spreads to the entire body.

 If you develop the symptoms described above: 

  • stay home;
  • avoid contact with babies under 12 months of age, pregnant women and people with immune system disorders.

Last week, Ottawa Public Health reported that an adult and a child from Ottawa are believed to have contracted measles while travelling abroad. Their diagnosis is the first confirmed measles case in Ottawa, as an outbreak spreads across Ontario, with more than 1,200 people affected. For more information about measles or to consult a nurse, dial 811.

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Prefect says she will fight for Low CLSC

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By Trevor Greenway

Chantal Lamarche says that she will do everything in her power to save the Low CLSC from closure. 

The MRC Vallée-de-la-Gatineau prefect said that she has been told by the CISSS de l’Outaouais (CISSSO) that the up-the-line clinic is on the chopping block and could be closed for good, as the regional health authority looks to cut another $30 million from its budget. 

“As [prefect], I refuse to see the disappearance of this local service, which is essential to our community,” wrote Lamarche in an email to the Low Down. “The building also houses home-care nurses, making it a critical point for our citizens. The chronic underfunding of the Outaouais for over 40 years must end. We demand that decisions take into account the reality of our territories.”

The Low CLSC has already been slashed down to one day a week, which has impacted Low residents, many of whom are elderly and immobile and can’t travel to Wakefield or Maniwaki to see a doctor. Lamarche said she is pressuring the CAQ government to “review these cuts and take into account the specific needs of the region.”

“It is imperative that alternative solutions be considered to ensure adequate funding and effective management of resources, thereby ensuring access to quality healthcare for all Outaouais residents,” she said.

CISSSO CEO Marc Bilodeau refused to comment on the potential closure and directed the Low Down to Santé Quebec for comment. Representatives of Quebec’s new non-partisan health department would not grant an interview and instead sent a statement saying that no decisions have been made on the closure of CLSCs in the province. 

“No changes are currently planned for the services offered at the various CLSCs,” wrote Santé Quebec’s media relations department. “Local services are important to the population, particularly those on the outskirts of urban areas. We are working to maintain them, despite the current difficult budgetary context.”

That “difficult budgetary context” is Santé Quebec’s austerity measures, in which it is looking to slash $1.5 billion from the province’s health budget by spring. The CISSSO already cut 800 health positions in the region earlier this spring. Another $30 million still needs to be cut from the CISSSO budget, which is why CLSCs in places like Low could be on the chopping block. 

SOS Outaouais’ Jean Pigeon told the Low Down that because CISSSO already cut services back to one day a week at the Low CLSC, patient numbers will naturally be down. The president of the regional health advocacy group said he worries CISSSO will use this data to show that the clinic isn’t getting used and therefore should be closed. 

“They test it, and then they say, ‘Well, nobody’s going to this point anymore.’ Of course! You’ve closed four days out of five days which you were open,” said Pigeon. “If there’s fewer services to offer, of course there’ll be less people that can use them. And then you shut it down, claiming that there’s no demand. It’s nonsense.”

Low seniors worry about home care 

With the potential closure of the CLSC in Low, seniors are beginning to worry if they will still be able to rely on home-care nurses who are based out of the clinic. Interim director-general of the Paugan Falls Seniors’ Residence Colette Canavan told the Low Down that she worries that it won’t be feasible for some seniors to grow old in Low. With an aging population, she doesn’t know where many of them will go. 

“What’s going to happen now with the cutbacks in home care, which they’ve cut a lot?” said Canavan.  “We’re going to see residents – seniors who are autonomous, but who need help – we’re going to see a possibility of having to say, ‘Sorry, you have to leave.’ So this is far more serious than what first appeared.”

Low council passed a resolution in late March decrying the cuts and demanding a meeting with local officials, including the region’s MNA, Robert Bussière. The motion touches on the potential closure, as well as language barriers for local residents. 

“[Low] stands united with its citizens in protesting these cuts and commits to advocating to the future well-being of all residents, ensuring transparency and proper communication regarding any proposed changes to local services,” the motion read. It was passed at Low’s council meeting on March 25 . 

Gatineau MNA Bussière did not respond to the Low Down’s questions. It’s unclear if he responded to Low council. 

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